| Research BackgroundAcquired Immune Deficiency Syndrome(AIDS)is an infectious disease that poses a serious threat to human health.Because the current medical technology is unable to fully cure AIDS,it has become a major global public health and social problems,and even had a tendency to spread.Modern medical treatment method is Highly Active Antiretroviral Therapy(HAART),it can effectively control the patient’s body viral load,reduce the opportunistic infection and reduce the spread of the virus,dramatically reduced the morbidity and mortality of AIDS.But the treatment need lifelong medication to patients with high resistance mutant strains,tolerance of drug adverse reactions,immune response,drug resistance and opportunistic infections,etc.The traditional Chinese medicine has curative effect is stable,and is famous for its side effects.Studies have shown that Chinese medicine treatment can improve immune function reconstruction,delay the onset,to reduce the opportunistic infection,improve the quality of life of patients.The adverse reactions to ease of HAART AIDS brings new methods and means.The traditional Chinese medicine research mainly concentrated in a few symptoms of AIDS observation and effective intervention solution mining,curative effect evaluation and immune function reconstruction,etc.And dynamic intervention of traditional Chinese medicine clinical syndrome differentiation and treatment efficacy and prognosis is insufficient,the lack of traditional Chinese medicine treatment of HIV/AIDS "Prescription-Syndrome-Effect" the dynamic trend of the target relations research,limits the traditional Chinese medicine treatment of AIDS clinical experience summary and promotion in nearly 30 years research and development of traditional Chinese medicine treatment of AIDS drugs listed.This study based on traditional Chinese medicine treatment of AIDS pilot project,based on 10,000 cases of traditional Chinese medicine treatment of HIV/AIDS retrospectively.Use a variety of statistics and machine learning methods,mining traditional Chinese medicine treatment of AIDS "Prescription-Syndrome-Effect" the relationship between dynamic target,to reveal the connotation of "plus and subtraction" treatment in AIDS Chinese medicine.Research purposesThis study is based on more than 10,000 retrospective cases of traditional Chinese medicine treating AIDS,Instrument for clinical technology of AIDS in Traditional Chinese Medicine(For Trial),etc.Using statistical analysis,propensity score matching,Multi-Link-LDA Topic model,methods of ARIMA time series model and so on method.Analyse of traditional Chinese medicine treatment of HIV/AIDS "Prescription-Syndrome-Effect" of the relationship between target dynamic trend.Through subgroup analysis,the population characteristics of the effective treatment of AIDS and the efficacy characteristics of the intervention were further clarified,for traditional Chinese medicine treatment of HIV/AIDS provide a scientific basis for clinical diagnosis and treatment and the prognosis of disease assessment.Research methodThis study included in August 2004 to December 2010 for traditional Chinese medicine treatment of AIDS cases data,using Multi-Link-LDA topic model,time-series and other analysis methods,research of traditional Chinese medicine treatment of AIDS "Prescription-Syndrome-Effect" the relationship between dynamic target.The specific steps are as follows:(1)Pre-processing the data of more than 10,000 cases of traditional Chinese medicine treating AIDS patients included in the analysis,including the basic information of patients,disease diagnosis and traditional Chinese medicine symptoms and signs,syndrome differentiation and treatment information,data standardization,outlier processing,missing value filling,etc.;(2)Descriptive statistical analysis method was used to conduct the baseline analysis of the included cases,including general demographic information,vital signs,infection route,syndrome distribution,and efficacy indicators;(3)Multi-level analysis of the dynamic characteristics of "Prescription-Syndrome-Effect" of traditional Chinese medicine treatment of AIDS.First,observation of traditional Chinese medicine treatment at 0-60 months respectively,each point syndrome,syndrome-intervention,the intervention plan scheme of the characteristics of the distribution and change over time.Second,the observation form than the highest syndromes,intervention plan,syndrome-intervention group CD4+T lymphocyte count(hereinafter referred to as the CD4 value).Finally,based on Multi-Link-LDA topic model,to establish Chinese medicine treatment of AIDS "Prescription-Syndrome-Effect" target.(4)For treatment,two groups of them is "Prescription-Syndrome-Effect" subgroup analysis of dynamic characteristics.First,according to Instrument for diagnosis and treatment of HIV/AIDS in Traditional Chinese Medicine(For Aldult),the patients were divided into effective and ineffective groups;Second,complete by propensity score matching method,two groups of baseline characteristics(including gender,age,ethnic group,marital status,educational level),and analyze the differences in the dynamic changes of syndrome,intervention program and intervention intervention between the two groups.(5)For two groups in the morning and evening to intervention "Prescription-Syndrome-Effect" subgroup analysis of dynamic characteristics.First,according to the intervention of traditional Chinese medicine treatment time in the morning and evening,to include patients respectively in early intervention group and late intervention group of Chinese medicine.Second,complete by propensity score matching method,two groups of baseline characteristics(including gender,age,nationality,marital status,educational level,infection,basal symptoms and signs),and analyze the differences in the dynamic changes of syndrome between the two groups.Finally,using the algorithm of ARIMA and trend forecast the curative effect of two groups of patients,respectively,include karnovsky score,total score of symptoms and signs of traditional Chinese medicine.This research adopts the SAS9.4 statistical analysis software,expressed as a mean and standard deviation measurement indicators,using t test data conforms to normal distribution,does not conform to the normal distribution with Wilcoxon rank and inspection.Classification count indicators compared with x2 inspection or Fisher’s exact probability method,input bilateral testing,P<0.05 credited with statistical differences.Using Multi-Link-LDA topic model to excavate traditional Chinese medicine to treat the target relationship of AIDS"Prescription-Syndrome-Effect",the ARIMA topic model was used to predict the prognostic efficacy trend.Group before and after treatment compared with matching test,accord with normal distribution,the paired t test,do not accord with normal distribution,the symbol rank and inspection.Research result1.Analysis results show that:in August 2004 to December 2010,Chinese medicine treatment of AIDS patients in Han ethnic group(89.08%)young men(36.78%)18 to 39 years old(55.63%),route of transmission is given priority to with paid blood supply(58.25%),Qi and Blood deficiency syndrome was the most common syndromes of AIDS(27.70%),the patient’s body temperature(36.5℃),respiratory(19 times/min),pulse(78 times/min),blood pressure(110/70mmHg)of the median were in normal range.2.Along with the advancement of treatment time,the syndrome population characteristics of AIDS patients are stable,ranking top four syndromes remains:Qi and Blood deficiency;Qi and Yin deficiency;Lung and kidney deficiency;Syndrome of obstruction by pathogenic dampness and spleen-kidney deficiency;Qi-deficiency and blood stasis,Pathogenic toxin indicates lag.Qi and Blood deficiency syndrome is always the most common syndromes AIDS.AIDS to deficiency syndrome and factors syndrome syndrome,deficiency syndrome has always been throughout the entire cycle of HIV/AIDS.On four types of syndrome groups after the intervention of traditional Chinese medicine CD4 value change tendency were analyzed,and found Qi and Blood deficiency syndrome CD4 value at 6,12,54 months improved statistically significant(P<0.05).3.Along with the advancement of treatment time,intervention plan adjust over time to a certain extent,the first four intervention plan are:Modified Bazhen Decoction;Yi AiKang capsule;QI lingyiqi pills and Modified Shenlingbaizhu powder,Modified Bazhen Decoction is the most commonly used intervention plan.For four kinds of intervention in patients with HIV/AIDS patients CD4 value tendency of the research,found Modified Bazhen Decoction treatment effect is better,with therapy in the treatment of 6 to 48 months ago CD4 value increase was statistically significant(P<0.05),CD4 value whole shows a slow steady rising trend.4.Along with the advancement of treatment time,the intervention program of traditional Chinese medicine for treating Qi and Blood deficiency syndrome is also changing dynamically,from the initial application of Modified Bazhen Decoction most eventually to the later application benefit Yi Aikang capsule,from 48 months after the application is love 4 at most.The four syndrome-intervention programs with the highest composition ratio were analyzed,found that Qi and Blood deficiency-Modified Bazhen Decoction in the treatment of 6 to 48 months when CD4 value to improve the statistical significance(P<0.05);Spleen and Stomach deficiency-Modified Shenlingbaizhu powder in the treatment of 30,54 months when CD4 value to improve the statistically significant(P<0.05),CD4 value whole shows a slow steady rising trend.The target relationship of Modified Bazhen Decoction treating Qi and Blood deficiency syndrome is stable,and the symptoms and signs are significantly improved.5.About effective and ineffective group people "Prescription-Syndrome-Effect"dynamic characteristics analysis,found along with the advancement of treatment time,the two groups syndromes are basically identical,Qi and Blood deficiency syndrome is the most common syndrome(40.43%in the effective group and 46.70%in the invalid group);Compared with the ineffective group,there were many kinds of traditional Chinese medicine intervention programs used in the effective group with obvious changes(Effective group intervention plan,there are 129 species in 12035 times invalid group intervention program there are 113 species in 8340 times);Compared with invalid group,Qi and Blood deficiency-Modified Bazhen Decoction(5.38%effective group 5.73%,ineffective group)and Qi and Yin deficiency,Lung and Kidney deficiency-Shengmai powder combined with Baihe Gujin decoction(2.13%effective group 1.19%,ineffective group)the composition of the two clinical recommended programs is relatively high,the combination of syndrome-intervention programs is relatively stable,and a certain regularity can be observed.6.Analysis of early intervention and late intervention in two groups of traditional Chinese medicine "Prescription-Syndrome-Effect" dynamic characteristic,two groups syndrome distribution is almost the same,Qi and Blood deficiency(early:41%;late:41.05%);Qi and Yin deficiency,Lung and kidney deficiency(early:12.31%;late:12.45%);Syndrome of obstruction by pathogenic dampness and spleen-kidney deficiency(early:12.73%;late:10.97%);Qi-deficiency and blood stasis,Pathogenic toxin indicates lag(early:8.29%;late:10.42%);Liver and Spleen deficiency(early:5.41%;late:5.05%)five types of syndrome of the highest.Found along with the advancement of treatment time,the change characteristics of syndrome are basically the same.Qi and Blood deficiency was the first from the treatment to the 60th month,and showed a gradually increasing trend,and the use of other syndrome was basically a gradually decreasing trend.By ARIMA model to predict total score of symptoms and signs of traditional Chinese medicine,karnovsky-score.Found that early intervention therapy of traditional Chinese medicine symptoms and signs of traditional Chinese medicine present the downward trend,the total integral curve and the late intervention treatment of symptoms and signs of traditional Chinese medicine always integral curve.Early intervention of Chinese medicine treatment of karnovsky-score,present the rising trend,integral curve and the late intervention karnovsky-score,integral curve leveled off.Analysis conclusion1.Along with the advancement of treatment time,the syndrome population characteristics of AIDS patients are stable,always given priority to with deficiency syndrome and factors syndrome,deficiency syndrome throughout the entire cycle of HIV/AIDS;Qi and Blood deficiency syndrome is one type of HIV/AIDS often witness types,Modified Bazhen Decoction is the most commonly used intervention plan;Qi and Blood deficiency-Modified Bazhen Decoction and Spleen and Stomach deficiency-Modified Shenlingbaizhu powder improve CD4 value is statistically significant,CD4 value showed a trend of slow rising steadily as a whole.2.For patients with HIV/AIDS diagnosis,early and long-term intervention therapy of traditional Chinese medicine in time,for patients with CD4 value keep steady even slow increase and improve patients.3.In the process of AIDS treatment in traditional Chinese medicine,based on Instrument for clinical technology of AIDS in Traditional Chinese Medicine(For Trial)the dosing schedule,at the same time to add and subtract,treatment based on syndrome differentiation is beneficial to giving full play to the advantages of traditional Chinese medicine treatment of HIV/AIDS clinical,improve the effect of treatment,and contribute to the reconstruction of autoimmune function of AIDS patients. |
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